The Case of a Patient with Concomitant Popliteal Artery and Ascending Aortic Aneurysm Who Presented with the Blue Toe Syndrome

Year 2015, Volume: 22 Issue: 3, 197 - 200, 14.12.2015

Tevfik Güneş , İhsan Alur Serkan Girgin Bilgin Emrecan

Abstract

Popliteal artery aneurysms (PAAs) are rare though these aneurysms are the most frequently encountered peripheral arterial aneurysms. In this article, we present the treatment of a patient who simultaneously had bilateral popliteal artery and ascending aortic aneurysm but was admitted to the emergency room due to the blue toe syndrome. A 72-old-year female was admitted to the hospital with left lower extremity pain and cyanosis in her toe. Bilateral popliteal artery and ascending aortic aneurysm were observed on computed tomography. Aneurysmectomy and femoropopliteal bypass was performed primarily to the left popliteal artery owing to ischemia. Two months later, we performed valve and ascending aorta replacement followed by right popliteal aneurysmectomy and femoropopliteal bypass 16 months later. In conclusion, since other arterial aneurysms can be simultaneously observed with popliteal artery aneurysm, it is very important to scan whole main arterial system when PAA is evaluated.

Key Words: Popliteal Artery; Aorta; Aneurysm; Embolism.

Keywords

-

Journal of Turgut Ozal Medical Center

Abstract

Popliteal arter anevrizmaları (PAA) nadir görülen patolojilerdir, fakat periferik arter anevrizmaları arasında en sık karşılaşılanıdır. Bu yazıda blue toe sendromu ile başvuran bilateral popliteal arter ve asendan aort anevrizması saptanan hastanın aşamalı tedavisi sunulmaktadır. 72 yaşında bayan hasta sol bacakta ağrı ve parmak uçlarında morarma yakınması ile acil servise başvurdu. Yapılan bilgisayarlı tomografik anjiyografisinde bilateral popliteal arter ve asendan aort anevrizması saptandı. Hastanın sol bacağı iskemik olduğundan öncelikli olarak sol popliteal artere anevrizmektomi ve femoropopliteal baypas uygulandı. 2 ay sonra kapak ve asendan aort replasmanı yapıldı ve 16 ay sonra sağ popliteal anevrizmektomi ve femoropopliteal baypas uygulandı. Sonuç olarak popliteal arter anevrizmalarına diğer arteriyel anevrizmalar eşlik ettiğinden saptandığında tarama yapılması çok önemlidir

Keywords

Popliteal Arter, Aort, Anevrizma, Emboli

References

• Kim SW, Chang JW A giant popliteal artery aneurysm treated with exclusion and bypass using a saphenous vein. Korean J Thorac Cardiovasc Surg. 2013;46(5):369-72.
• Mataracı İ, Büyükbayrak F, Şaşmazel A, Aksüt M, Sarıkaya S, Saçlı H ve ark. Popliteal arter anevrizma tanısıyla cerrahi onarım uygulanan olgularda erken ve geç dönem sonuçlarımız. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2009;(17):173-8.
• Huang Y, Gloviczki P, Noel AA, Sullivan TM, Kalra M, Gullerud RE et al. Early complications and long-term outcome after open surgical treatment of popliteal artery aneurysms: is exclusion with saphenous vein bypass still the gold standard? J Vasc Surg. 2007;45(4):706-713; discussion 713-5.
• Kaya E, Doğancı S, Kadan M, Erol G, Günay C, Demirkılıç U. Dev tromboze Popliteal Arter Anevrizması. Damar cer Derg 2012;21(2):171-4.
• Kropman RH, Schrijver AM, Kelder JC, Moll FL, de Vries JP. Clinical outcome of acute leg ischaemia due to thrombosed popliteal artery aneurysm: systematic review of 895 cases. Eur J Vasc Endovasc Surg. 2010;39(4):452-7.
• Dawson I, Sie RB, Van Bockel JH. Atherosclerotic popliteal aneurysm. Br J Surg 1997;84:293-9.
• Szilagyi DE, Schwartz RL, Reddy DJ. Popliteal arterial aneurysms.Their natural history and management. Arch Surg 1981;116:724-8.
• Moreno-Cabral CE, Miller DC, Mitchell RS, Stinson EB, Oyer PE, Jamieson SW, et al. Degenerative and atherosclerotic aneurysms of the thoracic aorta. Determinants of early and late surgical outcome. J Thorac Cardiovasc Surg. 1984;88(6):1020-32.
• Özler A, Tarhan İA, Kehlibar T, Arslan Y, Yılmaz M, Dumantepe M, et al. Blue toe syndrome following modified Bentall procedure: a case re port. Turkish J Thorac Car diovasc Surg 2010;18(3):220-1.
• Aulivola B, Hamdan AD, Hile CN, Sheahan MG, Skillman JJ, Campbell DR, et al. Popliteal artery aneurysms: a comparison of outcomes in elective versus emergent repair. J Vasc Surg 2004;39(6):1171-7.
• Michales JA, Galland RB. Management of asymptomatic popliteal aneurysms: the use of a Markov decision tree to determine the criteria for a conservative approach. Eur J Vasc Surg 1993;7(2):136-43.
• Lowell RC, Gloviczki P, Hallett J, Naessens JM, Maus TP, Cherry KJ, et al. Popliteal artery aneurysms: the risk of nonoperative management. Ann Vasc Surg 1994;8:14-23